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WHO health briefing on Iraq

WHO Information Officer Fadela Chaib has been working in Basra over the past two weeks. Here, she describes a visit to a black market for looted, diverted and pilfered medicines:

Selling looted medicines

I visited a street market in Al Hadi City (known as "Five Mile City") together with one of WHO’s international experts on disease control. What we found confirmed what we had heard – that medicines were on sale at the black market in Basra. Amidst the rubbish, muck and stagnant water , women were selling medicines wholesale and retail on little tables. We asked one of them what she recommended against diarrhoea, and she handed us a pack of pills. My colleague asked how often to take them, and the people who had gathered round started to laugh. With a very serious face, she held up three fingers, to indicate three times a day. The traders are mostly women, and most of them can neither read nor write. This is how they earn their living. In time they might get to recognise the medicines and what they are used for.

We asked the local health authorities about this trade. At present, many of the “treatments” endanger people’s lives. They explain that it began several years earlier. "When we, the physicians, make out prescriptions, the patients ask us to explain exactly how the medicines are to be taken. They buy them at the street market rather than at the pharmacy; they are cheaper there." In fact, the medicines at the market are half the price of those in pharmacies. It is a successful business in Basra, where ill health and poverty are rife.

The medicines come from various sources. Some are a result of the looting that has been going on for several weeks. Some have been stolen from health centres.

One Iraqi official tells us that before the war, the authorities made checks and confiscated merchandise, though they did not manage to stop the trade. Today, there are no checks at all because there are no representatives of the police or the authorities.. This phenomenon is not unusual in other countries, but had been rare in pre-war Iraq.

WHO links up with other organizations working for health to establish the best strategies for coordinating distribution of medicines. This is not an easy job. Donations arrive in Basra. Some are distributed directly to health centres, without the central authorities being informed. The authorities – and WHO – have one clear message: “donations are welcome on condition that they are brought directly to the central warehouse; failing that, the authorities should be informed at least of the quantity of medicines and their final destination." With coordination and centralization, distribution can be organised according to the needs of each centre and hospital. If we all work together in this way we should no longer have some health centres well supplied while others, especially in urban areas, suffer serious shortages.